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Abstract

Background and Purpose—Few dietary protein sources have been studied prospectively in relation to stroke. We examined the relation between foods that are major protein sources and risk of stroke.

Methods—We prospectively followed 84 010 women aged 30 to 55 years at baseline and 43 150 men aged 40 to 75 years at baseline without diagnosed cancer, diabetes, or cardiovascular disease. Diet was assessed repeatedly by a standardized and validated questionnaire. We examined the association between protein sources and incidence of stroke using a proportional hazard model adjusted for stroke risk factors.

Results—During 26 and 22 years of follow-up in women and men, respectively, we documented 2633 and 1397 strokes, respectively. In multivariable analyses, higher intake of red meat was associated with an elevated risk of stroke, whereas a higher intake of poultry was associated with a lower risk. In models estimating the effects of exchanging different protein sources, compared with 1 serving/day of red meat, 1 serving/day of poultry was associated with a 27% (95% CI, 12%–39%) lower risk of stroke, nuts with a 17% (95% CI. 4%–27%) lower risk, fish with a 17% (95% CI, 0%–30%) lower risk, low-fat dairy with an 11% (95% CI, 5%–17%) lower risk, and whole-fat dairy with a 10% (95% CI, 4%–16%) lower risk. We did not see significant associations with exchanging legumes or eggs for red meat.

Conclusions—These data suggest that stroke risk may be reduced by replacing red meat with other dietary sources of protein.